PRE 2010 DOCSVillage of Fridley, Minn.
BUILDING PERMIT
N? o , 100 Ofce of INSPECTOR OF BUELDINGS
� a
Owner -y, �.t a `�- { : �'r_,�
j� <r
Architect Fridley, Minn.,
Builder
LOCATION -0F BUILDING
f• Y.; yX .l ,. gyp.
No. t. !I street ` t ' � -�:,= ;� �'b '. Part of Lot
Lot Block Addition or Sub -Division
DESCRIPTION OF BUn DING
Front De th Height—/ Stories 0 Manner of Construction
To be used as r� '�� ` �` To be completed• s` a,' vJ Estimated Cost
a'
i
Permit is hereby granted to to
the buildinLy described in the above statement. This permit is granted
upon the express c a6 to whom it is granted, and his agents, employees and workmen, in ail
the work done in, around and upon sai building, or any part thereof, shall conform in all respects to the ordi-
nances of Fridley, Minn., regarding the construction, alteration, maintenance, repair and moving of buildings
within the city limits, and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
,-- tnspector of Buildings.
AGREEME_N'i' AND SWORN STATEMENT
In consideration of the issue and delivery to me by the Inspector of Buildings of Fridley of
the above permit, I hereby agree to do the proposed work in accordance with the description
above set forth and according to the provisions of the ordinances of Fridley, and, being first duly
sworn, I hereby state and say that the facts stated by me and contained in the above permit are
true as therein stated. J ,
el
Subscribed and sworn to before me at Fridley, Minnesota, is
day o .D. 19
Village of Fridley, Munn.
BUHMING PFif1[T
1�T
l�► ® 3 0 3 Office of INSPECTOR Or BUILDINGS
Owner Irk,
Architect Fridley, Minn.,
Builder
11
d•;,
LOCATION OF BUILDING
No. V2 �" " StreetPart of Lot
Lot Block Addition or Sub -Division
DESCRIPTION OF BUILDING
Front Depth Height Stories Manner of Construction
Permit is hereby granted
the building cribed in the above statement. This perp
upon the espres Ss ndition than; the person b w m it is ! anted, and his . agents, employees and wo
the work done in, around and upon said buil' g, or any part thereof, shall conform in all respect,
nances of Fridley, Minn., regarding the construction, alteration, maintenance, repair and moving
within the city limits, and this permit may be revoked at any time upon violation of any of the pros
ordinances.
Inspector
AGREEMENT AND SWORN STATEMENT
In consideration of the issue and delivery to , me by the Inspector of Buildings of
the above permit, I hereby agree to do the proposed work in accordance with the
above set forth and according to the provisions of the ordinances of Fridley, and, beir
sworn, I hereby state and say that the facts stated by me and contained in the above
true as therein stated.
Subscribed and sworn to before me at Fridley,
day oeA.D. 19.
Minnesota, this
,4.
Appladft for Pourer duets and IHouthg. Cooling. VeMationR RelripnMan and
Air Conditioning Sydow and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR:
RATE TOTAL
Furnace Shell & Duct Work ...........................$10.00
$
Replacement of Furnace .............................
6.00 $
Repairs & Alterations—up to $500.00 .................
6.00 $
Repairs & Alterations each add. $500.00 ...............
3.00 $
MECH. WARM AIR
Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $
each add. 60.000 BTU ....................... 3.00 $_
Replacement of Furnace ............................. 6.00 $
Repairs & Alterations--cp to $500.00 ................. 6.00 $
Repairs & Alterations each add. $500.00 .............. 3.00 $
STEAM or HOT WATER SYSTEM
Furnace Shell & Eines—to 400 sq. ft. FSR Steam .... . $10.00 $
Furnace Shell & Line—to 640 sq. ft. IDR Hot Water .. 14:00 $
Each add. 200 sq. ft. MR Steam ...................... &00' $
Each add. 320 sq. ft. MR. Hot Water ... . ........ ... 3.00 $
OIL BURNER—to 3 gal. per hour ... . ' ... .. , .. 6.00 $
over 3 gal. per hour --See Fee Schedule
GAS BURNER (up to 199,000 BTU) ......................... 600 $ _
over 199,000 BTU See Fee Schedule
GAS FITTING FEES:. NO RATE TOTAL
1st 3 Fixtures ..... x$ 200 $
Additional Fixtures ................. x .75 $
Gas Range to 199.000 ........... za `SAO $
AIR. CONDITIONING
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
FINAL 7 2 - � %- 17
See'Fee Schedule
TOTAL FEE
$ d`
Dept. of Bldga. Phone 860-3480
City of Fridley:
The undersigned hereby makes application for a permit for the work hereir
specified, agreeing to do all work in strict accordance with the City Ordinancef
and ruling of the Department of Buildings, and hereby declares that an the facts
and representations stated in this application are true and correct.
Fridley, Mn
Kind of Buildings r
Used as &\
To be completed about
Estimated est, $ —1,T,
�—
Old New. Building Permit No. Permit No. 40�7�YS
DESCRIPTION OF WORK
BEATING or POW39R PLANTS --,Steam, Hot Water. Warm Air—No
Trade Nam Size No l®
Capacity Sq. Ft. F:.DR BTU H.P.
Total Connected Load—��d� - Kind of Fuel
BURNER — Trade Name Size No -
Capacity Sq..Ft. ILDR- BTU H.P.
(M"Rus-OVER)
r
NA"
City of Fridley
Applica&n for Phm&bmg sad Cay FiMWq Famb
Dept. of Bldgs. Phone 560-3430
DESCRIPTION OF WORK d O
Number, Kind and Location of Fixtures
Location
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures .................. x $2.00 $
Future Fixture Opening ........... x $1.50 $ _
New Fixture Old Opening .......... x $1.50 $
Catch Basin .................... x $3.26 $
Water Heater 'Up to 99,000 BTU) . • . • x $3.00 $ 3
New Ground Run Old Bldg........ .
Elaotric Water Heater ..............
GAS FITTING FEES:
1st 3 Fixtures .............. • .
Additional Fixtures ................. .
Gas Range to 199.000 BTU ... — .......
REPAIRS & ALTERATIONS—Reiss to Code
_ x $3.26 $
$zoo $
NO. RATE TOTAL
— a $2.00 ; �-
x $ 36 $
x $6.00 ;
Description.............................................t _
TOTAL FEE ; �®
City of Fridley:
The undersigned hereby makes application for a permit for the- work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true and correct
Fridley, Minn 7— 192:0
Owner L
Kind of
Used as /L--.-, 1-1414—r
To be completed about
Estimated Cost, $
Old—New. Building Permit No. Permit No.
Signed
By�V:`'
Business Phune No 5�L3 -7 "' 9
ROUGH
SF
i�
Y
CO
V.3
<
(fin
(7!
•
/
•
N
WATER W".
GAS
ELEC.
Base
X
1st
2nd
3rd
4th
• T% Connection Openings
+ Now Fixture, Old Openings
conaadad with
Sewer
Cesspool ❑
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures .................. x $2.00 $
Future Fixture Opening ........... x $1.50 $ _
New Fixture Old Opening .......... x $1.50 $
Catch Basin .................... x $3.26 $
Water Heater 'Up to 99,000 BTU) . • . • x $3.00 $ 3
New Ground Run Old Bldg........ .
Elaotric Water Heater ..............
GAS FITTING FEES:
1st 3 Fixtures .............. • .
Additional Fixtures ................. .
Gas Range to 199.000 BTU ... — .......
REPAIRS & ALTERATIONS—Reiss to Code
_ x $3.26 $
$zoo $
NO. RATE TOTAL
— a $2.00 ; �-
x $ 36 $
x $6.00 ;
Description.............................................t _
TOTAL FEE ; �®
City of Fridley:
The undersigned hereby makes application for a permit for the- work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true and correct
Fridley, Minn 7— 192:0
Owner L
Kind of
Used as /L--.-, 1-1414—r
To be completed about
Estimated Cost, $
Old—New. Building Permit No. Permit No.
Signed
By�V:`'
Business Phune No 5�L3 -7 "' 9
ROUGH
N° 5155
Original Permit for PL SING AND GAS FI G ��
N.B. When work covered by this permit is ready, the Plumbing Ordinance requires that request for Permit
inspection shall be phoned in to the plumbing Inspector, 560-3450 giving number of this permit., Fee $ k
DESCBMTION OF WORK II
Number. Hind and Location of Fixtures
Stories
F
Z
e
Z
y
S
z Z
15
;
it 0
O Z
U 2
�' m
WO WATER HTR.
< J
6
Z
Q>Q
4 C
O
I
OJ a
Q Q
Q O
U
m x
.1
6 d
6 Q
3 U
7
m F
m
tl)
3 f
O LL
LL O
U dl
E
6A8 ELEC.
a LL'
Basement
1st
2nd
3rd
4th
Connecter with Sewer -Cesspool
Gas Piping for Openings
Permission is hereby granted to do the plumbing and
gas fitting in the building described in the statement hereto attach4 d upon the express condition that
the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing
or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and
this permit may be revoked at any time upon the violation of any of the provisions of said ordinances.
By Order Of The Inspector Of Buildings
Roughing in Inspection Date
Inspector.
Final Inspection Date
- Inspector.
42 1M -6.69-v
city of Fridley L ,190
Owner
Location
Kind of Building saw
Used as
To be Completed 9—,-60 , 19—�2D
Estimated Cost
Old -New. Building Permit No.
Date
Inspector of Buildings.
PERMIT for Power P ants and Heating. Cool-
ing. ventilation. Refrigeration and Air
Conditioning Systems and Devices
DESCRIPTION OF WORK
No. of Pleating Plants —H cto be 'nstal —altered—repaired
Make
Oil fired__; Coal fired ; Gas fired_ ��Gas Authorization No.
Remarks
Approved
Final Inspection
19_
Inspector
Permit N° 4756
Fee $ LT. 0 0
Office of the Inspector of Buildings
City of Fridley
City of Fridley, Minn. , 19-2-b
Owner
Location 1 ® Q
Kind of Buildin-g
How Occupied Q
Work to be Commenced—, 19—
To be Completed___a�Q,19
Estimated Cost, $%5�
Old -New, Building Permit No.
Permission is hereby granted to to install--erect—use the material and devices described in the
above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work
done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley
relating to or governing the work to be done and the operation of the devices herein named, and to the specifications set forth in the approved application for this
permit on file in the office of the Inspector of Buildings.
Inspector of Buildings
a2 2M11 -67V
City of Fridley 53-84-s915.51
Application for Plumbing and Gas Rtting Permit
Dept. of Bldgs. Phone 560-3450
DESCRIPTION OF WORK Location 664o Lmcia Lane
Number, Kind and Location of Fixtures
m
$
cc
$
x $1.50
$
x $3.25
Y
�gT�j
Z
O
aa
N
a
U
6
U' •�
W
C�9 Sn
Z
�O
•
F
•
N
WATER HTR.
GAS
EIEC
Base
6.00
1st
2nd
3rd
4th
• Future Connection Openings
* New Fixture, Old Openings
I
Connected with
Sewer E]
Cesspool p
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures .....................
Future Fixture Opening ................
New Fixture Old Opening ..............
Catch Basin ............................
Water Heater (Up to 99,000 BTU) ......
New Ground Run Old Bldg. ............
Electric Water Heater
GAS FITTING FEES:
1st 3 Fixtures ...... ...................
Additional Fixtures ...................
Gas Range to 199,000 BTU ...............
install (2) gas liters
REPAIRS & ALTERATIONS—Refer to Code
x $2.00
$
x $1.50
$
x $1.50
$
x $3.25
$
X $3.00
$
x $3.25
$
a $2.00
$
NO. RATE TOTAL
2 x $2.00
$ 2.00
x$.75
$
x $5.00
$
6.00
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true and correct.
Fridley, Minn- Ju1Y 151, 1970 , 19_
Owner Richard Huisinza
Kind of Building frame
Used as residence
To be completed aboutJU1Y 20. 1970
Estimated Cost, $_ 0 ,�
Older New. Building Pe •
Signe
By MINNEAPOLIS GAS CL
Business Phone No
ROUGH �/
FINAL '� j b r/ / 1
Description ................................................$
TOTAL FEE $ 8•00 az
SUBJECT
PER
City of Fridley
r
12563
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
1
/---1 CITY HALL FRIDLEY 55432
IL
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
---- it." t ,'J 812-580-3450
910-F15
5/29/74
JOB ADDRESS
6640 Lucia Lane N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
6B
Aud. Sub. #21 SHEET
2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE
Dorothy DuShav 6640 Lucia Lane N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Richard Hastings
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
7 CLASS OF WORK
❑ NEW ❑ ADDITION I$ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside Dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS
Caulk butt ends of siding
SEPERATE PERMITS REQUIRED FOR WIRING,
HEATING, PLUMBING AND SIGNS.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
Alum.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
R-1
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED,
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1,300.00
.65
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$9.00
STRUCTION OR TH PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$9.65
SIGNATU EOFCONTRACTORORAUTHORIZEDA NT 1 TE)
WHEN PROPERLX44,464QATED TIVS IS YOUR PERMIT
BLDG. )NSP ATE
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
APPLICATION FOR RESIDENTIAL, AI;TERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME: BUILDER:
NO:-.- l WO . STREET • Ukti Cly L=C�0
LOT: 616 . BLOCK: ADDITION:.. #.2t
CORNER. LOT: INSIDE LOT: SETBACK: SIDEYARD:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
�cQk..,Front : Depth: Height:
Square Feet: Cubic Feet:
.Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: Estimated Cost:
To Be Completed:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in stzi.ct accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct.
DATE: SIGNATURE:
(See Reverse Side For Additional Information.)
q'00
4
CITY OF FRIDLEY
8431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
Mr. & Mrs. Steven Hank
6630 Lucia Lane
Fridley, M 55432
Dear Mr. & Mrs. 'riank:
July 19, 1977
Subject: Driveway Damage at 6640 Lucia Lane
TELEPHONE ( 812)571.3450
On Thursday, July 7, 1977, a concrete driveway was poured at the
above referenced address as part of our street construction project.
f
rs you are aware, when the crew finished pouring the driveway and
left for the day at 4:30 p.m., one of your children rode their tricycle
across the driveway prior to its setting up and obtaining the strength
necessary for any type of travel across it.
On July 8, 1977, our crews tried to repair the damage done to the drive-
way. At this point, we are hoping that the repair will be successful,
therefore, this letter is to inform you that if our attempt to repair
the driveway is not successful, removal and replacement will be required.
If this becomes necessary, please be advised that the City will be obli-
gated to try to recover the costs due to the damage caused by your child.
We suggest that you check to see if this type of damage might be covered
under your homeowners insurance policy.
Ile will be contacting you in the future, updating you on the status of
any work that might be required. If you have any questions regarding
the information, please contact me.
TAC/grs
i
Sincerely,
CITY OF FRIDLEY
homers A. Colbert, P-.%.
Assistant City Engineer
1
SUBJECT
City of Fridley
17260
AT THE TOP OF THE TWINS
BUILDING P E R M I T
_
' '
T
• COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
( ®�
CITY HALL FRIDLEY 55432
NUMBER
TREv
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F159/23/83
JOB ADDRESS 6640 Lucia Lane N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
6B
Auditor's Subdivision #21 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Daryl Lundin 6640 Lucia Lane N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Hargo Construction Co. 3248 - 90th Avenue N.E. 784-4679
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION Lk ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Replace roof on garage and breezeway and wall in breezeway.
9 CHANGE QF USE FROM TO
STIPULATIONS
To be constructed as per the Building Code as discussed with Darrel Clark.
,-),EPERATE PERMITb REQUiREU FOR WjRj,�j,
HEATING, PLUMBING AND SIGNS.,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$3,000
$1.50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
ROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$38.50
RUCTION OR THE PERFORMANCE qF CONSTRUCTION.
PLAN CHECK FEE
TOT4AL FF_EO
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI
WHEN PROPERLY V DATED THIS IS YOUR PERMIT
el 9
SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI
BLDG IN P GATE
1
CITY OF FRIDLEY
APPLICATIM FOR RESIDENTIAL DUILDII;G PERMITS
(Rert, Alterations, Additions, or Repairs)
Effective Aug. 1, 1981
OWNER: � BUILDER:
Ar
y IN
ADDRESS:ADDRESS:�,� /VC
TEL H0: TEL 110:���T
Construction location
STRECT NO: STREET:
LOT: _ �� BLOCK: ADDITION:
Corner Lot: Inside Lot: Setback.: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certifi-sates to scale.
DESCRIPTION OF CONISTRUCTION
Front: Depth: Height:
Square feet: Cubic Feet:
Front: Depth:
Square Fent: cubic Feet:
Height:
Type of Construction: 4alar'e- Estimated Cost:
To Be Cbr-pleted:
�Alt. 'A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
SEE PZVFRR;L' SIDE OF SMEET
2be undersigned hereby makes applicAticn for a permit fcr the :.,ork herein specified,
agreeing to co.all work in strict accordance with the City of Fridley Ordinances and
rulings of the Departmait. of Buildings, and hereby declares that all the facts and
represmUttiens stated in this application are true and correct.
DT.TS: SIGNATUM :
Stipulations:
STATE OF MINNESOTA
DEPARTMENT OF HUMAN SERVICES
444 LAFAYETTE ROAD
ST. PAUL. MINNESOTA 55101
Date
Zoni Authority
X431
Street Address
�---
City1--l-State tZip Code
RE: ZONING NOTIFICATION OF APPLICATION FOR LICENSURE
Subject: G._.
Name of Day C re Home App cant
Street Address
S 43;�,
Cit State Zip Code
DHS -2722 (9-85)
PZ -027222-02
� V
Type of License:
Family Day Care
Group Family Day Care
Licensed Capacity / o
Phone No. S -7 1 -- t0"2,
This is to inform you that we are in receipt of an application for
licensure under Minnesota Rules, parts 9502.0300 to 9502.0445 (formerly
Rule 2), Family Day Care and Group Family Day Care Standards. Issuance of
this license is subject to compliance with the provisions of Minnesota
Statutes, Sections 245.781 to 245.812 and 252.28, subdivision 2, known as
the Public Welfare Licensing Act and the rules of the Department of Human
Services.
You should note that under Minnesota Statutes, Section 245.812, Subvision
3, a licensed day care facility serving 12 or fewer persons shall be
considered a permitted single family residential use of property for the
purposes of zoning. Subdivision 4 of the same section indicates that a
licensed day care facility serving from 13 through 16 persons shall be
considered a permitted multi -family residential use of property for
purposes of zoning.
If we do not hear from you within 30 days after receipt of this letter, we
will consider the above-mentioned day care home to be in compliance with
your local zoning code.
Sincerely,
lf UJ /1
Licensing Wor er
COMMUNITY HEALTH & SOCIA16
SERVICES DEPARTMENT
COUNTY OF ANOKA
COURTHOUSE. FOURTH FLOOR
ANOKA, M1NNFgn;:-55a163
Name of Agency/Organization
Street Address City State Zip Code
AN EQUAL OPPORTUNITY EMPLOYER
STATE OF MINNESOTA
DEPARTMENT OF HUMAN SERVICES
444 LAFAYETTE ROAD
ST. PAUL. MINNESOTA 55101
Date
'Zoniq Authority
H
treet Address
City 0 9tbLte Zip Code
RE: ZONING NOTIFICATION OF APPLICATION FOR LICENSURE
Subject: P_0_�
Name of Day Care Home A plicant
Street Address
rvi 0 . S S 3
City State Zip Code
DHS -2722 (9-85)
PZ-02722_02�-J %
Type of License:
Family Day Care %C
Group Family Day Care
Licensed Capacity
Phone No. J 9 ( --' .-I
This is to inform you that we are in receipt
licensure under Minnesota Rules, parts 9502.0300
Rule 2), Family Day Care and Group Family Day Care
this license is subject to compliance with the
Statutes, Sections 245.781 to 245.812 and 252.28,
the Public Welfare Licensing Act and the rules of
Services.
of an application for
to 9502.0445 (formerly
Standards. Issuance of
provisions of Minnesota
subdivision 2, known as
the Department of Human
You should note that under Minnesota Statutes, Section
3, a licensed day care facility serving 12 or fewer
considered a permitted single family residential use of
purposes of zoning. Subdivision 4 of the same section
licensed day care facility serving from 13 through 16
considered a permitted multi -family residential use
purposes of zoning.
If we do not hear from you within
will consider the above-mentioned
your local zoning code.
Sincerely,
K ",�- �
Licensing W rker
Street Address
245.812, Subvision
persons shall be
property for the
indicates that a
persons shall be
of property for
30 days after receipt of this letter, we
day care home to be in compliance with
COMMUNITY HEALTH & SOCIAL.
SERVICES DEPARTMENT
COUNTY OF ANOKA
COURTHOUSE. FOURTH FLOOR
ANOKA. MINNESOTA 88809
Name of Agency/Organization
City State Zip Code
AN EQUAL OPPORTUNITY EMPLOYER
PUBLIC WORKS
MAINTENANCE
DATE naromhor I?- 1 qRR
MEMORANDUM
/'�C
FROM Ral h Volkman Superintendent
TO
ACTION
INFO
SUBJECT
City Lot for Dump Site
John Flora Director/?* �L
x
Between 6640 and 6670 Lucia Lane, the City owns a lot that is a low area. We
are going to use this lot for a fill site for such materials as street sweep-
ings, dirt and blacktop from water breaks.
We have been clearing out some small trees and brush from the area to make it
more accessible for our equipment.
0
suedEcr
P IT NO.
City of Fridley
27220
AT THE TOP OF THE TWINS
BUILDING
PERMIT
�
R T NO.
`y COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
Iq
6�9
r
-3 C/Y
NUMBER
REV
DATE
PAGE OF
APPROVED BY
I".j CITY HALL FRIDLEY 55432
IL A,
--_•
612-571-3450
910-F15
18/17/98
JOB ADDRESSycia
k
6640 Lane
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
6B
I Sub. 21
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Sandra Hard
571-6307
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Four Seasons Roofiniz & Remodeliniz LLC 7930 Univ.Ave.NE Fridley
795-9410
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION fc REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage (17 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1417
@
$.71
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
ATE OR LOCAL LAW REGULATING CON-
PR�zf=le,'C4
STE OF CONSTRUCTION
48.50
Fire .SC $1.42
PLAN CHECK FEE
TOTAL FEE
fff
License 5.00
$55LA3
&NATURE OF CON'RACTO OR AUTHORIZED AGENT IOATEI
EN OPELIDAT D IS IS; Y2QR aMIT
BLD INsP
h E
S,GNATURE OF OWNER OF OWNER BUILDERi IDATEI
Effective 1/1/98
�t rCITY ; OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
,,BUILDING PERMIT APPLICATION
"r
tructionAddress: �� l L' h ` CA de, L h
.Ji::r e .:!
i
Description.
Name & Address: Tel.
4
J
.110
r: Lou rAU&M2j 1��;0� � .�
f ' LC G MN LICENSE #
Hr cig, hl✓e:� /(l�_Fr� c�.!- Tel. # 79J�-' `��/�.
LS
Attacli`'to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.{ '
DESCRIPTION OF IMPROVEMENT
ARfi A: Length Width Height Sq. Ft.
w E AREAS -" Length $ `1 `> Width Height Sq. Ft.
I) CIC AREA: Le Width Hgt/Ground Sq. Ft.
:'f-I'S12: Vb7 1AA IN 1.044
tion Type: Estimated Cost: $
(Fee Schedule on Back)..
:y Curb Cut Width Needed•' Ft. + 6 Ft = Ft x $
D:: i'E1*' : -- / L 91 ' APPLICANT:Tel. #
W ..,
"..CITY USE ONLY
KC k i"
_..:�:. Fee $k'� ,rFee Schedule on Reverse Side` L �'
:rcharge $°.00l�of Permit Valuation (1/10th%)
Surcharge $ � r$.507$f,000 Valuation
;. w
SAC Charge SAC Unit ry,
Umse Surcharge $5.00: (State Licensed Residential Contractors)
,-• ' '"r»ri.,d xZ'4t'9�1 ,� IP•fl - 11 tl
�::veway Escrow $ Alt, A.
or? B Above r
erosion Control $4 ,$450.00 Conservation Plan Review _ t
$ Fee Determined by Engineering
ti
:;�'„r_r Main Charge '$ _.:'Agreement Necessary [ ]. Not Necessary
TOTAL
F� p• rrt� ' v "i' x r,;; e r R �.?fdr 7rC`"`t""`n F ry,\
TO1AL
ua» A:
, 3 ✓ '• n-m -,: �i
STIPULATIONS �' }>r �x�K L :�._
.t
ZW
y � F • } 4N'��p�r t ..
e�
.NTY OF FRIDLEY INSPECTION DIV.
431 University Ave NE
'ridley, MN 55432
763) 572-3604, FAX (763) 571-1287
Effective April 1, 2004
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT _ ®®®�"
MAKK NUMBLK
UF FIA I UKES TO BE INSTALLED
ON EACH FLOOR
$10.00
)Id Opening, New Fixture
= Urinal
...
`.... o er
�.....
Wash t#::::::
Tray �ii�{< =
Floor
D raln
:>:::::: Auto.
'r:......
� Washer
:::::;;:::;::
�:;:�� `��:����
Gas
Range
:I� :;:::
Water Heater
Stone S
I"�I��<:
Gas Elec
Basemen t
>>
"Vater Heater - Gas**
$35.00
las Range**
$10.00
Sas Dryer**
$10.00
lack Flow Preventer Required ( )Yes () No
Type
Floor
Floor 2
FI
>>
I
F o0 r3
Floor 4
'LUMBING FIXTURE RATES: NO.
RATE TOTAL
Jew Fixtures
$10.00
)Id Opening, New Fixture
$10.00
leer Dispenser
$10.00
llow Off Basin
$10.00
;atch Basin
$10.00
Iain Water Leader
$10.00
'ump/Receiving Tank
$10.00
Vater Treating Appliance 9
$35.00
Vater Heater -Electric
$35.00
"Vater Heater - Gas**
$35.00
las Range**
$10.00
Sas Dryer**
$10.00
lack Flow Preventer Required ( )Yes () No
Type
$15.00
teinspection Fee $50.00/Hr
ILL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.25% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
JOB ADDRESS_ 6&&-Ae • aS &W IIVIAr
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the city codes
and rulings of the Building Division, and hereby declares that all the fads
and representations stated in this aaDlication are true and correct.
6640 LUCIA LANE NORTHEAST i U 20
FRIDLEY, MN 55432
OWNER _ (763) 571-1793
BUILDING USED AS SI edtG�
ESTIMATED COST W 1, 00 PERMIT NO.
PLUMBING
SIGNED BY
Approved By
lOVA
TEL NO. NIZ 827-cl033
Rough -In Date Final Date
v. v iv v■ vv
$ S OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE
'OOMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE
FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furnace, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No( )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes ( ) No( )
The undersigned also verifies that the replacement unit is a Iisted assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes ( ) No( )
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes () No( )
When required to install a new combustion air, it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes () No( )
When installing a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes ( ) No ( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes ( ) No( )
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type
BTU Input
Fan Assisted or Nat
Appliance #2 Type
BTU Input
Fan Assisted or Nat
Appliance #3 Type
BTU Input
Fan Assisted or Nat
Total Appliances
Total Btu Input
Common Vent Type
Vent Height
Diameter inches
Appliance #1 Vent Connector Height
ft Length
ft Diameter in Type
Appliance #2 Vent Connector Height
ft Length
ft Diameter in Type
Appliance #3 Vent Connector Height
ft Length
ft Diameter in Type
ALTERATIONS: (Describe)
HEATING CO:
Signed By:
_ f
Date:
CITY OF FRIDLEY INSPECTION
6431 U!iiversity Ave NE
Fridley, MN 55432
572.3604
RATE SCHEDULE
DIViSION
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Residential
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace,
but not replacement)
Gas Range
Gas Dryer
*Air Conditioning - All Sizes
All Others/Repairs & Alterations (LIST ON BACK)
1 Jo of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
Rate
$ 30.00
$ 10.00
$ 10.00
$ 10.00
$ 25.00
State Surcharge
TOTAL FEE
MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
Effective On January 1, 2000
JOB ADDRESS 6&V6 6 L,VC(A LAJ ,U,
OWNER DA/•!I2 d&Ris rA-tJ5bJ
TOTAL
BUILDING USED AS<tic
$ iI_ _00
ESTIMATED COST — PERMIT N0.
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air
$ Trade Name RUL) i:) Size No. (JG RAol)
BTU Q57oco0 HP EDR
$ •� Fuel 4V47—a A::5 Total Connected Load
Burner Trade Name Size No.
$ BTU HP EDR
$ The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the -City Codes an
$ .50 . rulings of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and correct.
$ SUPENOR CONTRACTO
812142NDAVENUEMA
��
HEATING (-
CRYSTAL, MN 55=
�,,�)
Signe q TEL #
Approved By Rough -In Date Final Date 1
COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No ( )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes () No
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes () No ( )
The existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes () No ( )
When required to install a new combustion air, it will be sized and installed
To meet the current codes and manufacturer's specifications. Yes( ) No(
When installing a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes () No ( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes( )No(
)
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type Rs,)D BTU Input Fan Assisted or Nat 9004seg-e,
Appliance #2 Type BTU Input Fan Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances Total Btu Input
Common Vent Type
Vent Height Diameter inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
ALTERATIONS: (Describe) A&)ceR fi::tJ RA)A-e— `t—
4� AVENUE NO.
HEATING C
ICTAL, MN 53422
Signed By: Date: